Native Americans with diabetes

Remarkable progress made reducing kidney failure from diabetes in Native American populations

Federal data show diabetes-related kidney failure among Native American adults (American Indians/Alaskan Natives) decreased 54 percent between 1996 and 2013. This remarkable decrease follows population-based approaches to diabetes management and improvements in clinical care begun by the Indian Health Service (IHS) in the mid-1980s.

Native Americans have a greater chance of having diabetes than any other U.S. racial/ethnic group.

Diabetes is the leading cause of kidney failure in the U.S. Two out of three Native Americans with kidney failure have diabetes. But the rate of diabetes-related kidney failure in Native Americans has declined the fastest of any racial/ethnic group in the U.S.

Kidney failure is a devastating and costly condition that requires regular dialysis or a kidney transplant for survival. Diabetes-related kidney failure is delayed or prevented by controlling blood pressure and blood sugar, using kidney-protective medicines, and regular kidney testing.

Key Findings from the report include:

Despite well-documented health and socioeconomic disparities in the Native American population, kidney failure from diabetes has decreased substantially since 1996.

IHS-supported care for Native Americans with diabetes has improved:

Use of medicine to protect kidneys increased greatly, from 42% to 74% in 5 years.

Average blood pressure in those with hypertension is well-controlled (133/76 in 2015).

Blood sugar control improved by 10% between 1996 and 2014.

More than 60% of Native Americans 65 years and older had a urine test for kidney damage (2015) compared to 40% of the Medicare diabetes population (2013).

The Indian Health Service applied strong coordinated clinical care and education, community outreach and environmental changes. These measure can make a dramatic difference in reducing complications from diabetes for all Americans.

Native Americans with diabetes.

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Native Americans with diabetes.

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Native Americans with diabetes.

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Team-based and population approaches reduce kidney failure from diabetes in Native Americans: can be a model for other groups.

Native Americans with diabetes.

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Kidney failure from diabetes in Native Americans has dropped more than any other race or ethnicity.

Native Americans are twice as likely as whites to have diabetes.

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In about 2 out of 3 Native Americans with kidney failure, diabetes is the cause.

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Kidney failure from diabetes dropped 54% in Native Americans between 1996 and 2013.

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Spokespersons

“The 54% decline in kidney failure from diabetes followed implementation of public health and population approaches to diabetes as well as improvements in clinical care by the IHS. We believe these strategies can be effective in any population. The patient, family, and community are all key partners in managing chronic diseases, including diabetes.”

Mary L. Smith – Indian Health Service Principal Deputy Director

“Reducing complications from diabetes, such as kidney failure, requires years of partnership between patients and their diabetes care team. Health care systems need to take the long view on the costs of providing comprehensive diabetes care versus the benefits of reducing expensive and disabling complications.”

Ann Bullock, M.D. – Director of the Indian Health Service’s Division of Diabetes Treatment and Prevention